No Plan B for health reform

If you think we are scrambling now to come up with a workable Plan B to deal with transportation gridlock after the defeat of the T-SPLOST last month, think about this:

There are no options on the table – in Atlanta or Washington – to get as many as 1.3 million Georgians health insurance as fast or as effectively as implementing the Affordable Care Act would.

Georgia is getting a grand bargain under the new health care law. In less than two years the federal government will pay 100 percent of the cost of the Medicaid expansion and no less than 90 percent after that.
Such a generous level of funding will not jeopardize the state’s $19.3 billion budget, as the governor’s office had to acknowledge recently.

Turning away our share of the $35 billion slated to come to Georgia through the ACA – funds that will go to other states that will happily use it to expand their Medicaid programs – seems a fool’s game. Yet that’s what Gov. Nathan Deal said he would do when asked about it by reporters at the Republican National Convention in Tampa.

While we play that political game, our people will remain uninsured, and New York, North Carolina, Ohio and other states will get to use our taxes to help their working families get the health care they need. Our tax dollars will in fact subsidize our business competitors in Charlotte and Knoxville … and that can’t be good for growing jobs in Georgia.

By expanding Medicaid, an estimated 650,000 Georgians will no longer rely on hospital emergency rooms to get their care for free but will have access to a doctor in their community.

A similar number will be able to purchase affordable coverage for the first time through private carriers selling plans on a statewide insurance exchange. If we don’t implement the new law, the nearly 2 million Georgia adults under age 65 will continue to go without health insurance, keeping us near the bottom among states in that dubious category. And this dismal statistic remains in place years after we have tried alternative plans that were supposed to reduce the number of uninsured and control costs.
You may remember some of these – caps on medical malpractice awards, mandated managed care for Medicaid recipients, the sale of bargain-basement, high-deductible plans, allowing insurers to get out of covering some benefits required by the state. It’s worth asking how those have worked for us.
Moreover, without the expansion, those of us with insurance will continue to pay higher and higher premiums and co-pays because hospitals, doctors and others have to offset the cost of caring for the uninsured.
By some estimates, this cost-shift or hidden tax inflates family premiums $1,000 a year. Why wouldn’t we want to get rid of this unofficial premium surcharge as soon as we can?
Still, the bottom line is this: Expanding Medicaid is simply the right thing to do. Most of the people expected to qualify under the new eligibility rules are the working poor – Georgians who work in low-wage jobs. They still have to pay the rent, buy food and clothing – as well as health insurance – on that income.
They can’t afford to wait for a Plan B that doesn’t exist. Neither can the rest of us.